People who Use Drugs: Stop TB Key Populations Brief

Globally, people who use drugs (PWUD) remain stigmatized and criminalized, which contributes to devastating health disparities, including extremely high rates of TB often combined with HIV and viral hepatitis. The range of these health issues and the prevailing lack of integrated health services capable of delivering TB, HIV, and harm reduction services in one place largely contribute to the scope of the TB crisis in communities of PWUD.

While the impacts of the TB epidemic are most acutely felt in PWUD communities in Eastern Europe and Central Asia, evidence is emerging from South and South-East Asia and sub-Saharan Africa that suggests that these issues are now universal. In countries where HIV epidemics are concentrated among PWUD and where rates of TB and multidrug-resistant TB (MDR-TB) are high, programme implementers and governments need to take immediate action, working alongside global and regional networks of PWUD and local PWUD activists to devise solutions that forgo punitive approaches to drug use and instead deliver effective and efficient results. Governments in other locales where TB epidemics among PWUD may be just beginning need to implement the necessary measures to engage communities of PWUD in all aspects of intervention planning, service delivery and impact evaluation. This guide outlines the key issues with access to TB prevention, treatment and care for PWUD, and provides recommendations for action and advocacy for communities, governments and donors.